Treatment of psoriasis/psoriatic arthritis has historically
followed a stepwise approach. Patients are initiated
on the first step with topical therapies and only progress
to the more aggressive therapies if they are unsuccessful
with the previous therapy.
|Step 1 - Topical therapy
|Step 2 - Phototherapy
||Step 3 - Systemic therapy
Vitamin D analogs
At the systemic therapy step, due to the limitations
of these agents, they are rotated to avoid cumulative
toxicity. This approach is not appropriate for all patients
as it often involves regimens that are inconvenient.
In addition, regular monitoring for serious side effects
Continuous control is difficult to achieve and many
patients become stuck in a cycle of successful therapy
followed by relapse. New approaches to the treatment
of psoriasis/psoriatic arthritis may allow physicians
to offer their patients long-term control with greater
confidence: the development of the new biological therapies
is changing the way psoriasis and psoriatic arthritis
Optimism has been brought to both psoriasis and psoriatic
arthritis treatments through the development of new
therapeutic options. The efficacy, safety, convenience
and improvements in quality of life achieved with these
new biological therapies are raising hopes that continuous
control can be achieved, the vicious circle can be broken,
and a new treatment paradigm can begin.
At an international conference in 2004, a consensus
statement was developed to establish how new therapeutics
should be incorporated into the armamentarium for the
treatment of psoriasis/psoriatic arthritis1..
Views from various countries around the world including
USA, Switzerland, and European and Latin American countries
were aired. The limitations of current therapies were
highlighted and the value of biological therapies for
psoriasis/psoriatic arthritis was discussed. It was
agreed that biologicals should be given equal consideration
among primary agents that are appropriate for patients
who are candidates for systemic therapy and guidance
was developed regarding the incorporation of biological
therapies into clinical practice.
There are many different therapies and treatment regimens
and it is important that you discuss these with your
dermatologist in order to find the best option for you.
Your local patient association will also be able to
provide you with a wealth of information, support and
guidance to help you.
You may find it useful to read stories about other
people who have had psoriasis and the journeys that
they have followed. The following are examples showing
how different treatments work for different people.
For more information, please contact the WPD secretariat:
9 Princeton Mews
167-169 London Road
Surrey KT2 6PT
Tel: +44 (0)20 8288 7840
Fax: +44 (0)20 8288 7844
1. Sterry W, Barker
J, Boehncke WH, Bos JD, Chimenti S, Christophers E,
et al. Biological therapies in the systemic management
of psoriasis: International Consensus Conference. Br
J Dermatol. 2004;151 Suppl 69:3-17.